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80 Cards in this Set
- Front
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What are some mechanisms of actions of corticosteroids important for treating inflammatory skin dz?
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inhibit transcription of cytokines, COX-2, vascular adhesion mols, transcription factors, iNOS, PLA2
neutrophils: neutrophilia, inhibit migration lymphocytes: lymphopenia (T cells), redistribution, ↓ activation eosinophils: inhibit migration |
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What factors are important in long term corticosteroid therapy?
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select intermediate acting corticosteroid
taper to lowest effective dose administer on EOD schedule to minimize side effects after long term therapy, it may take longer for adrenal gland recovery --> withdrawal syndrome may be observed in animals after glucocorticoids are discontinued |
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What is the dose of corticosteroids in dogs for:
a. physiologic b. anti-inflammatory c. immunosuppressive d. membrane stabilizing |
a. 0.25 mg/kg
b. 1.0 mg/kg c. 2.0 mg/kg d. 30 mg/kg |
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What are some differences in cats & horses vs. dogs when using corticosteroids?
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cats often require higher doses than dogs possibly d/t differences in receptors
cats, horses: prednisolone preferred over prednisone -either do no absorb prednisone orally well or once it is absorbed, there is a deficiency in ability to convert to prednisolone cats are more resistant to adverse effects than dogs repository forms of methylprednisolone acetate (Depo-Medrol) have been administered to cats: slowly absorbed over ~3 weeks |
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What are some adverse effects of corticosteroids with regard to the following body systems:
a. endocrine b. musculoskeletal c. GI |
a. HPA axis suppression, ↓ conversion of T4 --> T3, anti-insulin effects
b. ↓ collagen synthesis, osteoporosis, myopathy, laminitis (horses) c. ↑ risk of GI ulceration, diarrhea, ↑ risk of pancreatitis |
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What are some adverse effects of corticosteroids with regard to the following body systems:
a. immune system b. CNS c. metabolic d. renal |
a. ↓ immune response, ↓ wound healing, ↑ risk of infection
b. polyphagia, euphoria, restlessness, behavior changes c. hyperlipidemia, protein catabolism, steroid hepatopathy (dogs) d. PU/PD, recurrent UTIs (d/t ↓ immune response & PU/PD), sodium & water retention |
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In what patients should you use caution in treating w/ steroids?
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patients w/ DM, renal dz, GI dz, young growing animals, pregnant animals, animals requiring tissue healing (ex. surgical patients), patients on NSAIDs (don't give steroids)
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What are some clinical uses of omega fatty acids?
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pruritic dermatitis, arthritis, ulcerative colitis
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What is proposed mechanism of action of fatty acid supplements?
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arachadonic acid (a n-6 FA) --> COX & LOX --> inflammatory prostaglandins & leukotrienes (PG2, LT4 series)
FA supplements believed to compete w/ arachadonic acid for COX &/or LOX •n-3 FAs are either incapable of further metabolism to inflammatory mediators or are metabolized to less inflammatory mediators (PG3, LT5 series) |
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Which antihistamines are used to tx inflammatory skin conditions in dogs & cats?
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1st generation antihistamines: chlorpheniramine, diphenhydramine, hydroxyzine
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What are the pharmacological actions of antihistamines used to tx inflammatory skin dz?
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anti-inflammatory (antihistamine)
sedation (H1 blocking effect) antiemetic appetite stimulation antimuscarinic effects (atropine-like): dry mouth, urinary retention |
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What are the clinical effects of using antihistamines for tx of inflammatory skin dz?
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variable success in controlling pruritis & skin inflammation in animals
some drugs not absorbed in dogs more effective when combined w/ corticosteroids (can use lower steroid dose) |
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pentoxyifylline
a. drug class b. mechanism of action c. clinical uses in horses d. clinical uses in dogs e. reason why not used frequently |
a. methylxanthine
b. non-specific phosphodiesterase (PDE) inhibitor -phosphodiesterases hydrolyze cyclic AMP to 5’-nucleotide monophosphates -cyclic AMP important messenger that suppresses inflammation in cells in tissues -blocking PDE --> ↑ cyclic AMP --> anti-inflammatory effects, improved blood flow, inhibition of cytokine production c. navicular dz, laminitis, sepsis, endotoxemia d. vasculitis, contact dermatitis, dermatomyositis, atopic dermatitis e. has to be given q8h |
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What are the pharmalogical actions of cyclosporine?
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-more specific for T cells than B cells
-suppresses IL-2 (which normally activates T cells) & other cytokines -blocks proliferation of activated T lymphocytes -suppresses mast cell release -does NOT cause significant myelosuppression or suppress nonspecific immunity |
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What are some common clinical uses of cyclosporine?
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-suppression of immunity for organ transplantation
-atopic dermatitis -canine perianal fistulas -immune mediated dz -eosinophilic granuloma complex (cat) -feline asthma -KCS: topical tx -other uses: IBD, granulomatous meningoencephalitis, sebaceous adenitis, idiopathic sterile nodular panniculitis, IMHA |
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What are some pharmacokinetic issues associated w/ Atopica (vet formulation of cyclosporine)?
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oral absorption in dogs is highly variable (20-30%)
-better absorption if given w/o food, but ↑ incidence of vomiting intestinal metabolism by cytochrome P-450 (CYP) enzymes & efflux caused by intestinal p-glycoprotein (pumps absorbed drug back into SI --> eliminated) account for most of loss in systemic availability after oral administration -CYP inhibitors such as ketoconazole, diltiazem can inhibit pre-systemic metabolism of cyclosporine --> profound ↑ in systemic availability -can be used clinically to ↓ required dosage of cyclosporine & thus save money |
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What are some adverse effects of cyclosporine?
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nausea, anorexia, vomiting, shedding of hair, replaced by softer, glossier coat
less common: papillomas (dogs), gingival hyperplasia (dogs), toxoplasmosis (cats), tremors, convulsions, nephrotoxicitiy |
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What are the immunosuppressive actions of glucocorticoids?
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lymphopenia: primarily T cells
↓ MP function & production of cytokines suppression of cell mediated (T cell) immunity few direct effects on B cells |
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cyclophosphamide
a. mechanism of action b. clinical uses |
a. alkylate bases of DNA --> cross-links bases of DNA --> cessation of DNA synthesis --> cell death
-cytotoxic effect on lymphocytes: B cells effected more than T cells -can be used in combo w/ steroids that primarily work against T cells b. IMHA, immune mediated skin dz (ex. pemphigus foliaceus), systemic lupus, immune mediated joint dz (RA), cancer chemo (LSA) |
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azathioprine
a. mechanism of action b. clinical uses |
a. metabolized to active form 6-mercatopurine (6-MP)
-interferes w/ lymphocyte proliferation b/c it inhibits de novo synthesis of purines, which is critically important for activated lymphocytes -activated T cells most affected b. immune mediated skin dz, IMHA, IMTP, IBD, immune mediated arthritis (RA), graft rejection, acquired myasthenia gravis |
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azathioprine
a. pharmacokinetics b. adverse effects c. problems in cats |
a. onset of effects: 3-5 weeks
-long term therapy: administered EOD w/ prednisolone given on the alternate days b. idiosyncratic bone marrow suppression --> serious leucopenia, thrombocytopenia (monitor CBC continuously during therapy) -GI: vomiting, diarrhea (may be transient) -hepatotoxicosis: rare -pancreatitis: when given in combo w/ steroid (not well documented) c. more susceptible to toxicity than dogs -cats are deficient in TPMT, enzyme that converts 6-MP to non-toxic 6-MP nucleotides -can produce profound bone marrow suppression (neutropenia) in cats if used at dog dose --> if used, dose should be much lower |
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What drug classes can be used as anti-emetics?
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phenothiazines
antimuscarinics antihistamines metoclopramide serotonin antagonists glucocorticoids NK-1 receptor blockers |
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phenothiazines
a. mechanisms of action for tx of vomiting b. adverse effects c. drugs in class |
a. broad spectrum
-anti-dopaminergic: main effect -block α-1 receptors in vomiting center -some may also block histamine & muscarinic receptors b. sedation, ataxia, α-adrenergic block (hypotension), altered involuntary muscle activity (extrapyramidal signs; rare), seizures c. chlorpromazine, acepromazine |
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antimuscarinic
a. drugs in class b. mechanisms of action for tx of vomiting c. adverse effects |
a. atropine, scopolamine, aminopentamide (centrine)
b. block Ach at muscarinic receptors --> inhibit vomiting from vestibular stimulation & CRTZ c. xerostomia (dry mouth), ↓ stomach emptying, ileus, constipation, urine retention |
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antihistamines
a. drugs in class b. mechanisms of action for tx of vomiting c. adverse effects |
a. chlorpromazine, diphenhydramine
b. blocks H1 receptor --> weak antiemetic effects -histaminic nerve transmission stimulates vomiting from CRTZ, but this effect is apparently more prominent in dogs than cats c.sedation, antimuscarinic effects, excitement (cats) |
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metoclopramide: mechanisms of action for tx of vomiting
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inhibits dopaminergic transmission in CNS
↑ emptying of stomach & upper duodenum inhibits serotonin receptors (at high doses) |
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serotonin antagonists
a. example drug b. clinical use for tx of vomiting |
a. ondanesetron
b. most often used an antiemetic in cancer chemotherapy: very expensive |
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How is dexamesthasone used as a tx for vomiting?
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dec. GI inflammation: sometimes used in combo w/ other drugs to tx vomiting caused by cancer chemo
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NK-1 receptor blockers
a. example drug b. mechanisms of action c. clinical uses d. adverse effects |
a. Maropitant
b. antagonizes neurokinin (substance P): potent emetic at vomiting center & perhaps CRTZ -blocks vomiting induced from central & peripheral stimuli c. used primarily with drugs known to be highly emetic (ex. cancer chemo) d. none reported |
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What drugs are used for tx of motion sickness in:
a. dogs b. cats |
a. antihistamines, NK-1 blockers
b. phenothiazines |
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What drugs can be used to tx vomiting caused by drugs?
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choose drug that ↓ activity in CRTZ
ex. phenothiazines, metoclopramide, serotonin blockers, NK-1 blockers |
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What are the common clinical uses of GI pro-kinetic agents?
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post-op ileus (horses), GI motility disorders, gastroparesis (dogs), ↑ rumen motility, ↑ colon motility (cats, horses)
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What are 4 drugs commonly used as GI pro-kinetic agents?
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metoclopramide
cisapride erythromycin lidocaine |
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metoclopramide
a. mechanism of action b. pharmacologic effects |
a. dopamine (D2) antagonist, serotonin (5-HT4: stimulatory) agonist), serotonin (5-HT3: inhibitory) antagonist: at high doses
-proposed mechanisms: ↑ release of Ach in GI tract, ↑ sensitivity to Ach, antagonism of dopamine’s inhibitory action on GI motility b. ↑ tone of gastroesophageal sphincter -relaxes pyloric sphincter -↑ stomach emptying -↑ motility in proximal SI (little action in distal GI tract) |
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metoclopramide
a. clinical uses in small animals b. clinical uses in large animals c. adverse effects |
a. antiemetic, ↑ stomach emptying
b. ↑ intestinal motility, ↑ rumen motility -of little benefit to tx intestinal ileus in horses b/c it doesn’t stimulate colon c. antidopamine effects: sedation, involuntary muscle movements, ↓ seizure threshold -behavior changes, excitement: horses |
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cisapride
a. mechanism of action b. pharmacologic effects |
a.serotonin (5-HT4) agonist, serotonin (5-HT3) antagonist, may enhance release of Ach at myenteric plexus
-in cats: may directly stimulate smooth muscle motility via an unknown noncholinergic mechanism b. stimulates or restores motility along entire length of GI tract -coordinated motility stimulation -↓ esophageal reflux -↑ stomach emptying -↑ intestinal motility -↑ colonic motility |
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cisapride
a. clinical uses in small animals b. clinical uses in horses |
a. gastroesophageal reflux, ↑ stomach emptying, post-op ileus, constipation & megacolon
b. ↑ bowel motility, post-op ileus (not used much anymore: no IV form) |
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erythomycin
a. mechanism of action as GI pro-kinetic agent b. pharmacologic effect c. adverse effects |
a. ↑ activation of motilin receptors (low doses)
b. ↑ gastric emptying (does not effect distal GI tract) -NOT drug of choice b/c it fails to restore normal motility pattern c. can cause diarrhea in horses thru effect on normal intestinal flora |
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lidocaine
a. pharmacologic effects b. clinical use in horses |
a. ↓ sympathetic tone
-direct excitatory effects on intestinal smooth muscle -inhibition of pain stimulus b. IV infusion for tx of post-op ileus |
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What drugs/drug classes are used to tx &/or prevent GI ulcers?
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antacids
H-2 blockers sucralfate proton pump inhibitors misoprostol |
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antacids
a. example drugs b. mechanism of action c. adverse effects d. drug interactions |
a. magnesium hydroxide (Milk of Magnesia), calcium carbonate (Tums), aluminum hydroxide (Amphogel)
b. neutralize stomach acid to form water & neutral salt -may stimulate local prostaglandin synthesis c. not absorbed --> lack serious systemic effects -diarrhea, constipation, alkalosis at high doses d. cations interfere w/ drug absorption: fluoroquionolones, tetracyclines -↑ stomach pH can interfere w/ drug absorption: ketoconazole, itraconazole |
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H-2 blockers
a. drugs in class b. mechanism of action c. clinical uses |
a. cimetidine, ranitide, famotidine
b. block histamine H2 receptor on gastric parietal cell --> inhibit gastric acid secretion, ↑ gastric pH c. gastritis, gastric ulcers, duodenal ulcers, GI ulcer prevention, esophagitis, mast cell tumors, hypergastrinemic syndromes -ranitidine most commonly used in horses: better oral absorption |
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H-2 blockers
a. adverse effects b. drug interactions c. miscellaneous effects |
a. good safety record
b. cimetidine inhibits CYP-450 enzymes --> inhibits clearance of some drugs (others less likely to cause such a rxn) c. stimulate intestinal smooth muscle: ranitidine, nizatidine -anti-cholinesterase action --> ↑ gastric emptying, ↑ colonic motility -clinical benefits uncertain immunologic effects: not well established -cimetidine can block H2 receptors on suppressor T cells --> ↑ lymphocyte responses to mitogen stimulation -cytoprotection in GI tract: cimetidine may strengthen gastric mucosal defenses against ulceration by ↑ bicarb secretion |
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sucralfate
a. mechanism of action b. side effects c. clinical use d. drug interactions |
a. dissociates in acid milieu of stomach to sucrose octasulfate & aluminum hydroxide
-creates a protective effect by binding to ulcerated mucosa --> prevents back diffusion of H+ ions & inactivates pepsin -↑ local synthesis of prostaglandins b. not absorbed systemically: virtually free of side effects c. prevention & treatment of gastric & intestinal ulceration -little evidence of efficacy for preventing NSAID induced ulcers d. aluminum may inhibit absorption of some drugs (ex. fluoroquionolones, tetracyclines) |
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proton pump inhibitors
a. example drug b. mechanism of action c. acid suppression & efficacy |
a. omeprazole (Prilosec)
b. inhibit H+/K+ proton pump at luminal surface of gastric parietal cell --> inhibits secretion of H+ ions into stomach lumen c. very potent acid suppressing drugs (10-20x cimetidine) w/ long lasting effects (~24 hrs) -weak bases that favor accumulation in acid environment of parietal cells -may be delayed onset before they achieve maximum efficacy -superior to other antisecretory drugs for tx of NSAID induced ulcers -inhibitory effect against Helicobacter |
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proton pump inhibitors
a. clinical uses in dogs b. clinical uses in horses c. drug interactions |
a. used in dogs that need potent, long acting acid suppression, dogs w/ NSAID induced ulcers, or dogs that fail to respond to other anti-ulcer drugs
b. treatment & prevention of ulcers (OTC formulation available: UlcerGuard) c. ↑ gastric pH may ↓ oral absorption of some drugs (ex. ketoconazole, itraconazole) |
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misoprostol
a. mechanism of action b. clinical uses c. adverse effects |
a. synthetic PGE-1 analog
b. prevention of NSAID induced ulcers (not as useful for treating existing ulcers) c. abdominal discomfort, mild vomiting, diarrhea, do NOT use in pregnant animals |
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What are some roles of prostaglandins in the GI tract?
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-protection of GI mucosa
-stimulation of protective mucus & bicarbonate secretion -stimulation of blood flow -anti-inflammatory effects -stimulation of cell turnover & repair |
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What are some tx regimens for Helicobacter gastritis?
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2 drug combinations: bismuth + AB, omeprazole + AB
3 drug combinations: bismuth + 2 AB’s, omeprazole + 2 AB’s ABs: Metronidazole, Amoxicillin, Clarithromycin |
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What drugs/drug classes are used to tx diarrhea?
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kaolin-pectin formulations
bismuth subsalicylate antimuscarinics opiates tylosin metronidazole |
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kaolin-pectin formulations
a. mechanism of action b. effectiveness |
a. binding of bacterial toxins in GI tract (proposed)
b. clinical studies have failed to show benefit from use may change consistency of stools, but will not ↓ fluid or electrolyte loss, nor will it shorten duration of illness |
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bismuth subsalicylate
a. effects of bismuth b. effects of subsalicylate |
a. may have some ability to adsorb bacterial endotoxins, anti-Helicobacter effect
b. anti-inflammatory (some PGs mediate secretory diarrhea) -active ingredient: absorbed systemically |
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antimuscarinics
a. drugs in class b. mechanism of action for tx of diarrhea c. why are they rarely used? |
a. atropine, scopolamine, buscopan
b. block Ach at muscarinic receptors --> inhibits smooth muscle tone in intestines, inhibits intestinal secretions c. questionable efficacy for most diarrhea seen in vet med (few cases are classified as “hypermotile”) -intestinal motility is already impaired in some patients w/ diarrhea & these drugs may worsen diarrhea by creating a “stove pipe” effect -adverse effects: ileus, xerostomia, urine retention, cycloplegia, tachycardia, CNS excitement |
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N-butylscopolammonium bromide (Buscopan)
a. drug class b. clinical use |
a. antimuscarinic
b. registered for tx of spasmodic colic in horses -do not use in colic caused by impaction |
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opiates
a. example drug used to tx diarrhea b. effects on GI tract c. adverse effects |
a. loperamide (Imodium)
b. GI effects: ↑ tone of sphincters (intestinal, biliary), ↑ segmental tone, ↓ propulsive activity, ↑ water absorption c. contraindicated in infectious diarrhea b/c may significantly slow GI transit time & ↑ absorption of bacterial toxins few CNS effects: membrane pump p-glycoprotein helps remove drug -dogs that are deficient in p-glycoprotein (ex. Collies) may be prone to toxicity |
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tylosin
a. drug class b. clinical use in tx of diarrhea |
a. macrolide AB
b. chronic diarrhea in dogs w/ unknown etiology -large & small intestines may be affected -diarrhea may be caused by bacteria & has an inflammatory component -treated animals respond quickly to tx (< 3 d) & relapse quickly when therapy is discontinued |
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metronidazole: clinical use in tx of diarrhea
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used to tx chronic diarrhea caused by GI protozoa (ex. Giardia), anaerobic bacteria
ant-inflammatory effect: ↓ cell mediated immune response |
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What antimicrobials are used to tx diarrhea in calves?
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oral amoxicillin x 3d. or systemic ceftiofur
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sulfasalazine
a. metabolism b. effects on GI tract c. clinical use d. adverse effects |
a. prodrug: combination of sulfapyridine & 5-aminosalicylic acid (mesalamine)
-broken down by bacteria in colon to release 2 drugs -sulfonamide component absorbed into circulation -salicylic acid component remains active in GI tract b. salicylate component: ↓ PGs, LTs, ↓ IL-1, oxygen radical scavenging activity c. drug of choice for initial tx of ulcerative or idiopathic colitis, or plasmacytic-lymphocytic colitis after dietary therapy has been attempted d. sulfonamide component is absorbed & can produce adverse effects in some animals, such as KCS in dogs -cannot use in patients that have allergic rxns to sulfonamides |
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budesonide
a. drug class b. clinical uses |
a. locally acting corticosteroid
b. limited use for tx of diarrhea in dogs & cats -coated tablet: coating does not release drug until pH > 5.5 (distal GI tract) -if any is absorbed, 80-90% inactivated by 1st pass metabolism: systemic steroid side effects minimal |
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opiates
a. drugs used as antitussives b. mechanism of action |
a.
hydrocodone: most often used in vet med -similar to codeine in action, but more potent -combined w/ an anticholinergic drug (homatropine) in Hycodan: added to discourage abuse -efficacy has not been established in animals dextromorphan: not a true opiate -suppresses medullary cough center -lacks opiate receptor effects: analgesia & addiction -antitussive efficacy questionable -poor absorption in dogs butorphanol: µ antagonist, κ agonist -potent antitussive -poorly bioavailable: oral dose higher than IV or SQ dose -high doses may induce side effects such as sedation b. directly depress cough center in medulla w/o binding to traditional opiate receptors |
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What are the pharmacologic effects of B-2 agonists used as bronchodilators?
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relax airway smooth muscle
relieve bronchoconstriction inhibit release of mediators from mast cells ↑ mucociliary clearance: significance unknown |
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How is epinephrine used to tx respiratory dz?
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drug of choice for emergency tx of life-threatening bronchoconstriction
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terbutaline
a. drug class b. clinical use |
a. B-2 agonist
b. most commonly used β-2 agonist in small animals (lasts longest) -long acting: 6-8 hours -not absorbed after oral administration in horses |
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clenbuterol
a. drug class b. clinical use c. adverse effects d. restrictions to use |
a.partial B-2 agonist
b. tx of choice for heaves (RAO) in horses c. sweating, muscle tremors, restlessness, tachycardia d. use illegal in food animals -β-2 agonists have been used as repartitioning agents: repartitions nutrients away from adipose tissue in favor of muscle -residues pose threat to people (pregnant women, people w/ heart conditions) |
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What are some adverse effects of B-2 agonists?
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excitement, muscle tremors, hyperthermia, tachycardia, ventricular arrhythmias, tolerance w/ chronic use
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theophylline, aminophylline
a. drug class b. mechanism of action |
a. methyxanthines
b. non-specific phosphodiesterase (PDE) inhibitor -phosphodiesterases hydrolyze cyclic AMP to 5’-nucleotide monophosphates -cyclic AMP important messenger that suppresses inflammation in cells in tissues blocking PDE --> ↑ cyclic AMP --> inhibits release of inflammatory mediators from mast cells, anti-inflammatory effects, bronchial smooth muscle relaxation -improve diaphragmatic strength, ↑ mucociliary clearance |
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theophylline, aminophylline
a. clinical uses in SA b. clinical uses in horses c. adverse effects |
a. bronchoconstrictive airway dz, collapsing trachea, allergic bronchitis, COPD
b. heaves (RAO): not used much d/t narrow therapeutic index & incidence of adverse effects (excitement, tachycardia) c. ↑ risk of arrhythmias, excitement, tremors, ↑ risk of seizures, vomiting, nausea |
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What corticosteroids are commonly used to tx respiratory dz in:
a. dogs b. cats c. horses |
a. oral prednisone/prednisolone is usually drug of choice
b. oral prednisolone, IM methylprednisolone acetate (Depo-Medrol) c. dexamethasone, prednisolone |
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What are the clinical uses of corticosteroids in respiratory dz?
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bronchoconstrictive dz, heaves (RAO), allergic bronchitis, feline asthma, COPD, airway inflammation
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fluticasone
a. drug class b. adverse effects c. species used in |
a. inhaled corticosteroid
b. minimal systemic adverse effects: significant 1st pass effects prevent systemic blood concentrations if it is swallowed after delivery c. cats, horses |
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benzodiazepines
a. behavior drugs in class b. mechanisms of actions c. clinical uses |
a. diazepam, alprazolam (Xanax)
b. activate benzodiazepine receptors in CNS, facilitate GABA (inhibitory neurotransmitter) in CNS c. fears & phobias, anxiety (urine spraying) |
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buspirone
a. mechanism of action b. clinical uses c. adverse effects d. additional considerations |
a. serotonergic & dopaminergic mechanisms
b. urine spraying, separation anxiety, thunderstorm phobia (numerous uses) c. GI (uncommon) d. may require 1-3 weeks to take effect -no potential for abuse |
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tricyclic antidepressants
a. drugs in class b. mechanism of action c. clinical uses |
a. clomipramine, amitriptyline
b. block uptake of serotonin & norepi c. control of aggression, urine spraying, anxiety, hypervocalization, compulsive disorders |
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tricyclic antidepressants
a. adverse effects b. additional considerations |
a. anticholinergic (dry mouth, urinary/fecal retention), sedation
b. bitter taste -may require 2-4 weeks to take effect -contraindicated w/ cardiac conduction abnormalities, seizures -not recommended for breeding males -OD potential for pets & humans: no antidote -metabolized by CYP 450 enzymes: concurrent use of cimetidine, etc. --> high serum concentrations of TCA |
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selective serotonin reuptake inhibitors
a. drugs in class b. mechanism of action c. clinical uses |
a. fluoxtine (Prozac), paroxetine (Paxil)
b. blocks reuptake of serotonin c. separation anxiety, urine spraying, compulsive disorders, aggression |
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selective serotonin reuptake inhibitors
a. adverse effects b. additional considerations |
a. anorexia, nausea, diarrhea, anxiety, irritability, insomnia
b. fluoxetine: may require 3-4 weeks to take effect -gradually ↑ dose over 2 weeks to ↓ side effects |
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monoamine oxidase-B inhibitors
a. example drug b. mechanism of action c. clinical uses d. drug interactions |
a. selegiline (Anipryl)
b. irreversibly inhibit monoamine oxides, inhibit catabolism of catecholamines (esp. dopamine) c. cognitive dysfunction & sleep disorders in dogs d. risk of serious drug interactions, esp. w/ TCAs, SSRIs, other MAOIs (ex. amitraz) |
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benzodiazpines
a. side effects b. additional considerations |
a. sedation, ataxia, muscle relaxation, polyphagia, paradoxical excitation, memory deficits, idiosyncratic hepatic necrosis in cats given oral diazepam (rare), discontinuation rxns
b. may disinhibit aggressive behavior -rapid onset of action -short T1/2 in dogs -after chronic use, withdrawal gradually to avoid discontinuation syndrome |
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What conditions is clomipramine registered for?
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approved for tx of separation anxiety of dogs in US & for tx of compulsive disorders in Canada
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